FINALLY!

Kerry Ketring, DVMDiplomate, ACVO

All Animal Eye ClinicCincinnati, Ohio

www.allanimaleyeclinic.com

A CURE FOR CATARACTS !

or not . . . .or not . . . .

A New Product?

Homeopathic drops have been available over the counter for many years.

Over the years, other drugs have been proposed to dissolve cataracts.

OTC Ocular ProductsHomeopathic

Old and Ineffective Drug

“Preliminary Observations on Orgotein Treatment of Canine Cataract.”

Modern Veterinary Practice. 1977, Dec; 1009-12.

Palosein™ (Orgotein), which has superoxcide dismutase activity, was injected intraocular to dissolve cataracts. Subsequent testing showed it to be ineffective.

Recent Ads JAVMA, February 2006

(N-Acetyl-L-Carnosine or NAC)

“loss of the quality of life”– NO!

Change in lifestyle – possibly

Clients routinely report their blind dogs have adapted and are enjoying a high quality of life.

Recent Ads Website, February 2006

These “comments” are subjective, without a scientific basis.

In my nearly 30 years of practice, I have had literally hundreds of owners tell me how thrilled they were that their blind pet’s appetite and activity level returned to normal once they were comfortable.

www.cataract-clear.ch/petdrops.htmAnother NAC Product

Human Preparations of NAC

Innovative Vision Products

US corporation operating in Russia

MBI Distributing aka Molecular Biologics manufacture and/or distribute:

Bright Eyes, Bright eyes II, Oxydrops,Visitein, Can-C

Another Human NAC Product

Here’s the !or not . . . .or not . . . .

I and every veterinary ophthalmologist I have been in contact with over this product, agree we want to see the raw data that substantiate this company’s claim.

83% Improvement?

Confirmed by……owner?veterinarian?veterinary ophthalmologist?

His owner believes he is visual.

Owners frequentlymisjudge how much vision their pet has.

Misinterpretation of Signs By Owner

Beagle, 7 years oldRx for 6 months with “Russian

cataract dissolving drug”Owner reported it had helped

because cataract is smaller.

Misinterpretation of Signs By Owner

A miotic pupil, posterior synechia, and secondary glaucoma are present.

Tests veterinarians use to gauge vision include menace response, dazzle reflex, and pupillary light response.

Problems administering or interpreting these tests can lead to incorrect evaluation of vision.

Misinterpretation of Signs By Veterinarians

Misinterpretation of Signs By Veterinarians

Dazzle Reflex A positive dazzle does not mean the

dog is visual, only that the optic nerve, retina and facial nerve are functioning.

Menace Response A visual acuity of 20/20,000 can still elicit a menace response for hand movement at 2 feet!

Misinterpretation of Signs By Veterinarians

Misinterpretation of Signs By Veterinarians

Pupillary Light Response A positive pupillary light response

does not indicate vision because it can be present in a dog with a blindingcataract and even in a dog with SARD.

Ophthalmologists’ Evaluations

“No animals with overt cataracts improved.”Milton Wyman DVM, Dipl ACVO

February, 2006Online correspondence

Future Veterinary Ophthalmology article-“The only trouble is that there is indeed a very small improvement in some cataracts with OcluVet™…but certainly not sufficient to make any visually impaired dog sighted again.”

David L. Williams MA VetMB PhD CertVOphthal MRCVSSt. John’s College, Cambridge

Online correspondence

It has been implied veterinary ophthalmologist are denying the efficacy of this drug because they fear a reduction of income from cataract surgery.

This implication is an insult to the integrity of all veterinarians.

Cash Cow?

OcluVet™ (N-Acetyl-L-Carnosine or NAC)

Nutritional / lubricant eye drop therefore not subject to FDA approval.

NAC is an antioxidant / antiglycation nutrient.

At your cost of $91.00 a bottle, it would cost $1.51 a day to treat a dog with bilateral cataracts for the first 2 months.

The following cases are examples of patients whose vision improved. Had they been on NAC, this drug would have been given credit for the improvement.

“Miracle Cures” Without NAC

“Miracle Cures” Without NACResorbing Cataracts

Siberian Husky, 9 month old

Initial phacolytic uveitis Post Rx, one month later

Cocker Spaniel, 3 years old

Initial phacolytic uveitis 3 months post-Rx, pupil dilated

“Miracle Cures” Without NACResorbing Cataracts

“Miracle Cures” Without NAC

Mixed breed, 9 year old diabetic

Initial phacolytic uveitis 2.5 months post-Rx, pupil dilated

Resorbing Cataracts

Alternatives Magazine---February 2006“Cataracts Drop Right Away”

Reports on the enormous benefits of NAC drops…

There are, however, other explanations for cataracts appearing to “drop” away.

“Miracle Cures” ?

Poodles, both 14 year old

Spontaneously regained vision

Posterior Cataractic Lens Luxation“Miracle Cures” Without NAC

“Miracle Cures” Without NAC

Poodle, 4 year old

Spontaneously regained vision

Dense nucleus has fallen inferior in the fluid cortex

Morgagnian Cataract

“Do No Harm”

No one has suggested the application of OcluVet™ is damaging or irritating to the eye except for hair coat discoloration.

However, it has been used in cases misdiagnosed as cataracts, and in individuals with unrecognized, associated phacolytic uveitis. Both situations resulted in inadequate therapy and detriment to the animal.

The following cases illustrate this point..

Misdiagnosis

Basset9 years old

Endothelial dystrophyand nuclear sclerosis

Pekingese5 years old

Keratomalacia

Cocker8 years old

Posterior luxationand glaucoma

Cocker9 years old

Lens resobtion andsecondary glaucoma

Misdiagnosis

Miniature Schnauzer, 6.5 years old

DiabeticRx for 14 days with OcluVet™Now severe phacolytic uveitis.

This condition progressed to secondary glaucoma and bilateralenucleation.

Hope for the Future

There are promising studies in cataract prevention for diabetic dogs. A whole new class of drugs is being investigated.

Aldose Reductase Inhibitors

The aldose reductase inhibitor Kinostat, applied topically, shows potential in preventing the progression of diabetic cataracts when applied prior to their onset or in early stages.

Drs. Kador, Betts, Wyman, et alACVO 2005 presentation

Diabetic Cataracts

Siberian Husky9 months oldEarly diabeticcataract

Rottweiler9 years oldImmature diabetic cataract

Keeshond9 years oldEarly diabeticcataract

Labrador Retriever5 years oldMature diabeticcataract

Final Comments

To date, I and the majority of veterinary ophthalmologists have not been convinced the efficacy of this drug has been scientifically proven.

I and the majority of veterinary ophthalmologists feel that the AVMA was premature in accepting this advertisement.

I am speaking for myself and not on behalf of the American College of Veterinary Ophthalmologists.

I and the many veterinary ophthalmologists I have been in contact with over these NAC products agree we want to see the

raw data that substantiates their claims.